What question did this study set out to answer?

To evaluate the implementation and adoption of detailed electronic health records in English secondary care to inform ongoing local and national rollouts.

September 1, 2010BMJOpen Access

Implementation and adoption of nationwide electronic health records in secondary care in England: qualitative analysis of interim results from a prospective national evaluation

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To evaluate the implementation and adoption of detailed electronic health records in English secondary care to inform ongoing local and national rollouts.
Conducted a mixed-methods, longitudinal, multisite socio-technical case study across five NHS acute hospital and mental health trusts in England.
Gathered data via semi-structured interviews, observational field notes, organizational documents, and quantitative metrics.
Analyzed qualitative data thematically using a socio-technical coding matrix alongside inductively emerging themes.
System development and deployment progressed far slower than planned, necessitating a shift from rigid top-down standardization toward greater local customization.
Centrally negotiated vendor contracts created rigid deployment timelines, fragmented communication pathways, and software poorly suited to evolving clinical workflows.
Stakeholders strongly preferred a 'middle-out' implementation strategy that pairs central government governance with local trust autonomy and data sharing.

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Implication

Longitudinal case study reveals delayed adoption of electronic health records across hospital trusts, suggesting that flexible middle-out implementation strategies improve clinical utility.

Cite This Study

Robertson et al. (2010) studied this question.

synapsesocial.com/papers/6a82a2fc0f52607ca18addaf https://doi.org/10.1136/bmj.c4564

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Implication

Longitudinal case study reveals delayed adoption of electronic health records across hospital trusts, suggesting that flexible middle-out implementation strategies improve clinical utility.

Implementation and adoption of nationwide electronic health records in secondary care in England: qualitative analysis of interim results from a prospective national evaluation

Key Points

Discussion

Implication

Cite This Study

Implementation and adoption of nationwide electronic health records in secondary care in England: qualitative analysis of interim results from a prospective national evaluation

Key Points

Discussion

Implication

Cite This Study

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